干扰素治疗慢性特发性血小板减少性紫癜的临床探讨

Clinical Study on Interferon Treatment of Chronic Idiopathic Thromboc ytopenic Purpura

为探讨干扰素治疗慢性特发性血小板减 少性紫癜（cITP）的疗效及其毒副反应， 采用干扰素α-2a（3MIU i.m.每周1次，共8周）和强的松〔1mg/(kg·d)，共4周〕分 别治疗20例 和28例cITP患者，并观察治疗前后血小板计数、骨髓涂片巨核细胞计数、免疫学指标、网织 血小板（RPs）百分率和绝对计数，以及巨核祖细胞集落数的变化。结果显示：干扰素治 疗 组的近期有效率（90.00%）明显高于强的松组（64.28%，P＜0.05）。经治疗后RPs%降 低， 产板型巨核细胞百分率由11.43%升至33.19%，但各项免疫学指标无显著变化。结论：干扰素 是一 种治疗cITP的有效药物，而且毒副反应小。其作用机制可能与促进巨核细胞分化成熟及血小 板生成增多有关。

The efficacy and mechanism of interferon alpha-2a (IFN α-2 a) were assessed in the treatment of chronic idiopathic thrombocytopenic purpura (cITP). 20 patients with cITP (treatment group) were treated with IFNα-2a 3MI U i.m. once a week for 8 weeks; 28 patients with cITP(control group) were treate d with prednison e 1mg/(kg穌) for 4 weeks. Blood platelet counts (BPC), megakaryocyte number, immu nno logical parameters, percent and absolute counts of reticulated platelets (RPs) a nd megakaryocyte colony formation units were observed before and after therapy. The results showed that the efficacy of IFN α-2a was better than that of corti co steroid, P＜0.05. The RPs% decreased and the plateletproducing megakaryocy te percentage increased from 11.43% to 33.19% significantly after IFN α2a th erapy, but there were no significant changes in immunnological parameters .These indicate that IFN α-2a is effective in treating cITP, the mechanism may be ba sed on promoting the megakaryocyte development and activating the production of platelets.